TRICARE Overseas Program Provider Manual

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TRICARE overseas Program Provider Manual Since 1998, International SOS has supported TRICARE in ensuring that Active Duty Service Members and their families receive the highest quality care, no matter where their work or travels take them. About International SoS International SOS (http://www.internationalsos.com) is the world's leading medical and travel security risk services company. We care for clients across the globe, from more than 700 locations in 89 countries. Our expertise is unique: approximately 11,000 employees are led by 1,200 doctors and 200 security specialists. Teams work night and day to protect our members. Since 1998, International SOS has supported TRICARE in ensuring that Active Duty Service Members (ADSM) and their families receive the highest quality care, no matter where their work or travels take them. About Defense Health Agency and the Military Health System Defense Health Agency (DHA), the Defense Department activity that administers the health care plan for the uniformed services, retirees and their families, serves more than 9.5 million eligible beneficiaries worldwide in the Military Health System (MHS). The mission of the MHS is to enhance Department of Defense and national security by providing health support for the full range of military operations. The MHS provides quality medical care through a network of Providers, Military Treatment Facilities (MTF), medical clinics and dental clinics worldwide. What is the TRICARE overseas Program? TRICARE is a comprehensive health care program provided to active and retired members of the United States uniformed services, their spouses and children, survivors and certain other beneficiaries. On October 21, 2009, International SOS was selected by DHA as the contractor for the TRICARE Overseas Program (TOP) in locations outside the 50 United States and the District of Columbia. International SOS began delivering health care services on September 1, 2010. TOP is designed to enhance existing operations, improve Provider satisfaction and deliver high-quality, patient-centered care for nearly half a million beneficiaries overseas. For TRICARE beneficiaries living overseas, TOP will offer options including TOP Prime, TOP Prime Remote and TOP Standard as 6
TRICARE overseas Program Provider Manual SECTIoN 1 About International SoS and the TRICARE overseas Program well as TRICARE for Life, TRICARE Reserve Select, TRICARE Retired Reserve, and TRICARE Young Adult. International SOS is developing a network of Providers primarily to support TOP Prime and TOP Prime Remote beneficiaries. We recognize that TOP Standard beneficiaries may also choose to seek care from some Network Providers. The TOP Prime program delivers the prime benefit to ADSM and their families in the three overseas areas: Eurasia-Africa, the Pacific, and Latin America and Canada. The TOP Prime Remote program delivers the prime benefit to ADSM and their families stationed in designated remote locations overseas. International SoS TRICARE Contact Information If you have any questions about claims, payments, how to become a Network Provider or credentialing and certification requirements, please contact your TOP Regional Call Center. Customer Service Phone Numbers Europe, Middle East & Africa +44-20-8762-8384 TRICARE overseas Program Provider Manual overview Latin America and Canada +1-215-942-8393 Puerto Rico +1-877-867-1091 This TOP Provider Manual has been developed to provide you and your staff with basic, important information about the TRICARE Overseas Program (TOP). The manual will assist you in coordinating care for TOP beneficiaries. It contains detailed information about TOP programs, policies and procedures. Additional TOP program information can be found online by visiting www.tricare-overseas.com. Providers can also visit the TRICARE website at www.tricare.mil. TRICARE program manuals are available in their entirety at the DHA Manuals website. Thank you for your commitment to the Department of Defense overseas military community. Asia-Pacific +65-6339-2676 Australasia +61-2-9273-2710 If a patient attends an appointment and you require assistance with determining eligibility, covered benefits, or receiving prior authorization for care, please contact the Medical Assistance lines below: Medical Assistance Phone Numbers Europe, Middle East & Africa +44-20-8762-8133 Latin America and Canada +1-215-942-8320 Puerto Rico +1-215-942-8320 Asia-Pacific +65-6338-9277 Australasia +61-2-9273-2760 Visit www.tricare-overseas.com for a full listing of toll free phone numbers by country. This website will be updated regularly, as additional information becomes available. 7
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